1) Scheme of division of methods of patient's examination

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Lecture ? 3 Theme General examination
(check-up) The plan of lecture
1) Scheme of division of methods of patient's
examination 2) Rules and conditions of general
check-up 3) Plan (succession) of general
check-up
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Severity of the state assessment
Readings Severity degree Severity degree Severity degree Severity degree
Readings Satisfactory Moderate severity Grave condition Emergency condition
1) State of consciousness Clear consciousness Clear or torpor Clear or clouded consciousness. Sometimes conscious depression (torpor, soporific state), delirium Extremely depressed (up to coma). Rarely clear.
2) Position in bed Active Forced or active self-service Passive of forced patient's position. Inability to self-service. Psychomotor excitation. Permanent bedside nursing. Passive. Motor excitation, general convulsions.
3) Temperature Normal or subfebrile temperature High temperature Hyperpyretic fever or hypothermia Various
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Severity of the state assessment (continuation)
Readings Severity degree Severity degree Severity degree Severity degree
Readings Satisfactory Moderate severity Grave condition Emergency condition
4) Skin and subcutaneous fat Normal General oedema. Marked pale skin or moderate cyanosis Anasarca. Chalk-like pallor or marked cyanosis. Ashen (pallid) pinched shape face with death-damp (Hippocratic face)
5) Cardiovascular system Normal pulse 60-90 bpm, blood pressure (BP) 110-140/60-90 mmHg Tachycardia (pulse gt90 bpm) or bradycardia (less than 60 bmp). Cardiac rhythm disturbances. Hyper- or hypotension. Thread-like pulse, considerable rise or fall in blood pressure (BP). Only carotid pulse available. BP can not be detected.
6) Respiratory rate 16-20 per minute More than 20 per minute Up to 40 per minute (tachypnea) Up to 60 per minute
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Severity of the state assessment (continuation)
Readings Severity degree Severity degree Severity degree Severity degree
Readings Satisfactory Moderate severity Grave condition Emergency condition
7) Other symptoms Symptoms of basic disease Vomiting, diarrhea, gastro-intestinal bleeding. Rapid progress and serious adverse events are highly possible. Uncontrollable vomiting, profuse diarrhea, massive gastro-intestinal bleeding (vomiting coffe-ground, tarry stool melena). Diffuse peritonitis. Stertorous respiration during total pulmonary oedema. Pinky foamy sputum. Disturbances in respiration Kussmaul respiration, periodic Cheyne-Stokes respiration.
8) Function vitals Compensated Decompensa-tion is not hazardous Decompensation is hazardous and may result in invalidity Serious dysfunctions of vitals
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Severity of the state assessment (continuation)
Readings Severity degree Severity degree Severity degree Severity degree
Readings Satisfactory Moderate severity Grave condition Emergency condition
9) Character of disease Mild form of the disease recovery period after acute diseases, softening after exacerbation of chronic diseases Disease with objective and subjective manifestations Complications with marked and progressive clinical sings Rapid exacerbation, dangerous acute complications
10) Medical tactics Indications for admission to hospital Emergency aid and hospitalization Urgent hospitalization transfer to the Intensive Care Unit (ICU) Resuscitation department